It has been a while since I thought of writing about it. I couldn't write because I felt I am being too harsh to myself. It defiantly takes a toll on you to think critical about what you do. I am Prasanna Hegde, Program Director - Deglutology and Speech-Language Pathology, working at a tertiary cancer center in Bengaluru. Lot has happened in the past 4 years in capacity building for dysphagia rehabilitation. Every day's quest is "What's the next big thing?". With a focus to collaborate, achieve difficult goals and being motivated constantly I am being supported by a dynamic leader at work place. It is a 'temple run' situation in my professional life. This is the phase which is bringing out the best in me, in the environment that I work and the people I work with. Engaging in clinical services, establishing evidence base and skill training in dysphagia rehabilitation and head and neck rehabilitation, we are creating manpower for the landscape of India in this domain. In the midst of a dynamic phase of professional life, there is a feeling that often looms in my mind asking me "Are you selling a dream?".
What dream am I referring to? It is that luxury a Speech-Language Pathologist wishes to have: Professional working environment, supporting healthcare professionals and most important is to have freedom to work in the way that is deemed right by self. These factors bring out the best in any professional. Yes, this is a common sight at my workplace. Having trained with us, interacting with the team of healthcare professionals and full realization of scope of practice, it is natural for any passing out trainee to expect a similar working environment elsewhere.
Unfortunately, ideal seems to be not real. Often our trainees let us know that we are preparing a product/service for a non-willing market. When I say non-willing, it means that it exists but there are factors that decide the utilization of product/service. Unfortunately, our service is still referral based and healthcare in India is still doctor advised but not disease/dysfunction driven. Focus on incorporation of cutting edge technology has led to ignorance of some of the basic necessities of patient care. Somehow, even when there is no need of finances to get a service going, reasons are easy to find not to support or approve it.
It was not a cake walk for me to have reached the prime of my clinical practice in speech and swallow, but I am not sure if I can tell my students with pride that "Do you know how much struggle I had to go through to reach here?". Realization and acknowledgment may be required on these efforts but not necessary one has to go through the same struggle.
With that realization, it is today that I stand with a goal to change the landscape of dysphagia practice in India in 5 years using various methods of advocacy in addition to training, research, and collaboration. We usually talk public awareness, but more important is professional awareness. There are still practitioners who prescribe time as a medicine for healing. WHO ICF model of patient care is still a mirage.
I personally feel a student should not join back the training institute as it might reduce the scope of learning for both student and the teacher. Our training shall be for bigger requirement than just to fill our needs. Hence, yes I am selling a dream with absolute possibility which I am working towards creating. Everybody in our lives teaches us something. Some teach to "what to do" and some "what not to"!!
Wish you all a meaningful Gurupoornima!!
- Prasanna Hegde